PLEASE COMPLETE THE FOLLOWING INFORMATION AND MAIL or E-MAIL TO:

Louisburg Cider Mill                                               Directions:

14730 Highway 68                                                    3 miles west of

Louisburg, KS 66053-8223                                     Louisburg, Kansas

Phone: 913-837-5202                                              on Highway 68

Fax: 913-837-5762

E-mail: lcmill@mokancomm.net

Group Name:                                                           Date:                              

Contact Person:                                              Phone:                                     

Address:                                                        Fax:                                          

City, State, Zip:                                                                                               

E-Mail Address:                                                                                              

Estimated No. of Children:                  Estimated No. of Adults:                     

Requested Time & Date for Tour:                                                                   

Tour Package:                          “A”(tour only)--$3.00 per person…includes children & adults who will be eating doughnut & cider)

                                                  “B” --$5.00 per person…includes tour, cider & doughnut, & hay wagon ride.

                                                  “C” --$8.00 per person (tour w/ cider &  doughnut, hayride, children’s play area & pumpkin patch. A small pie pumpkin

                                                           will be given to each child).

PAYMENT MUST BE MADE PRIOR TO THE BEGINNING OF YOUR TOUR.